Abstract

Background

Medication errors have received extensive attention in recent decades and are of significant concern to healthcare organisations globally. Medication errors occur frequently, and adverse events associated with medications are one of the largest causes of harm to hospitalised patients. Reviews have suggested that up to 50% of the adverse events in the medication process may be preventable. Thus the medication process is an important means to improve safety.

Purpose

The objective of this study was to evaluate the effectiveness of two automated medication systems in reducing the medication administration error rate in comparison with current practice.

Material and methods

This was a controlled before and after study with follow-up after 7 and 14 months. The study was conducted in two acute medical hospital wards. Two automated medication systems were tested: (1) automated dispensing cabinet, automated dispensing and barcode medication administration; (2) non-patient specific automated dispensing and barcode medication administration. The occurrence of administration errors was observed in three 3 week periods. The error rates were calculated by dividing the number of doses with one or more errors with the number of observed doses (opportunities for errors). Logistic regression was used to assess changes in error rates after implementation of the automated medication systems.

Results

A total of 269 doses with one or more errors were identified out of 3216 doses administered. The complex automated medication system effectively reduced the overall risk of administration errors in the intervention ward (OR 0.53, 95% CI 0.27–0.90), and the procedural error rate was also significantly reduced (OR 0.44, 95% CI 0.126–0.94). The non-patient specific automated medication system effectively reduced the clinical error rate in the intervention ward (OR 0.38; 95% CI 0.15–0.96).